The follow-up chest X-Ray after a diagnosis of community acquired pneumonia: for the patient’s benefit or the physician’s satisfaction?

Le résumé fourni par la source

Introduction: Follow-up chest X-rays (CXRs) are recommended in some guidelines after a pneumonia to exclude the possibility of lung cancer, although the benefit of this practice remains questionable. Methodology A follow-up study was conducted in a tertiary care setting, recruiting 100 patients who fulfilled the inclusion criteria using continuous sampling. Results: Median age of the cohort was 80 years (range 31-96) and 15 were under 65 years. 57% were males and 3 patients had normal CRP on admission. 67% had CRP >100. The majority of patients had right-sided pneumonia (42%) and 28% had bilateral pneumonia. 34 patients had multilobar pneumonia. All patients were COVID negative at the time of pneumonia diagnosis. 20 patients did not have a follow-up chest X-ray. 58 patients fully recovered in follow-up CXRs and 16 partially. Six follow-up CXRs showed new/increased changes. Two patients from the group were diagnosed with cancer during the 3-year follow-up period. One of the patients underwent a CT angiogram during the initial admission, which was normal. However, 21 months later, he was diagnosed with metastatic tongue cancer. The other patient had a follow-up CXR 4 weeks later which was normal. 9 months after the initial admission, a full body CT scan was performed due to the patient’s anaemia, detecting a lung nodule. This was kept under surveillance. None of the patients were diagnosed with primary lung cancer. Conclusion: Follow-up CXR after a diagnosis of bacterial pneumonia has not added any benefit in primary lung cancer diagnosis, and authors would not recommend this. Larger studies are suggested to prove this further.

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